IMPACT OF RESTENOSIS 10 YEARS AFTER CORONARY ANGIOPLASTY

Aims The aim of the study was to compare the 10-year follow-up results of patients with or without restenosis following single-vessel percut aneous transluminal coronary angioplasty (PTCA). Methods and Results A total of 313 patients with successful PTCA (greater than or equal to 20% reduction in luminal diameter narrowing without acute complication s) and a control angiography 6 months after PTCA were included in the study. Events during the follow-up period were defined as death, myoca rdial infarction, bypass surgery, or repeat PTCA. Statistical evaluati on was performed by the Fisher test, logistic regression, and life-tab le analysis. Restenosis (loss of >50% of the initial gain and diameter stenosis of <50%) was found in 87 (28%) patients. During follow-up, 1 1 patients (5%) without restenosis (group A) and 11 (13%) patients wit h restenosis (group B) died (P<0.05). In group A, 17 (8%) patients and in group B, 11 (13%) patients suffered myocardial infarction (ns); 17 group A (8%) patients and 25 (29%) group B patients had bypass surger y (P<0.0001), and 34 (15%) group A patients and 55 (63%) group B patie nts underwent repeat PTCA (P<0.0001). Logistic regression analysis ide ntified restenosis as an independent risk factor that increases the ri sk of death 2.8-fold (P=0.02), bypass surgery 5.6-fold (P<0.0001), and repeat PTCA 10-fold (P<0. 0001). Conclusion: We conclude that patient s with restenosis had a poorer long-term outcome than patients without restenosis. Although most patients with restenosis underwent repeat P TCA, the survival rate without any serious adverse events was only 59% , compared with 83% in patients without restenosis (P<0.0001).